[Benign retroperitoneal schwannoma in patient with antecedents of Willm's tumor in the infancy]. / Schwannoma retroperitoneal benigno en paciente con antecedentes de tumor de Wilms en la infancia.

We report a case of benign retroperitoneal schwannoma diagnosed casual in a 23 years old woman treated of a Wilm's tumour twenty years ago. A review of the on this unusual tumour is included.

Schwannoma retroperitoneal benigno en paciente con antecedentes de tumor de wilms en la infancia / Benign retroperitoneal schwannoma in patient with antecedents of wilm´s tumor in the infancy

Se presenta un caso de schwannoma benigno retroperitoneal como hallazgo incidental en una joven de 23 años tratada de un tumor de Wilms a los tres años. Se incluye una revisión de la literatura de este tumor tan infrecuente (AU)

[Endoscopic treatment of congenital paraureteral diverticuli and cavities]. / Tratamiento endoscópico de los divertículos y cavidades paraureterales congénitos.

We report 4 cases of primary congenital paraurethral diverticula or cavities (3 diverticula and 1 cyst of Cowper's glands) that were treated by endoscopic surgery. All the foregoing cases were diagnosed as primary in the absence of coexisting pathologies or associated disorders. The wall between the diverticulum and the urethral lumen was sectioned endoscopically. All patients recovered normal clinical and morphological status.

[Blind bifid ureter associated with duplicity and contralateral vesicoureteral reflux]. / Uréter bífido ciego asociado a duplicidad y reflujo vesicoureteral contralateral.

We report on a pediatric patient who was evaluated for recurrent episodes of urinary tract infection. Evaluation by IVP, cystography and retrograde ureteropyelography revealed a complete ureteral duplicity, grade II vesicoureteral reflux in the lower half of the left kidney and a blind bifid ureter arising at the distal third of the right ureter. This is an uncommon condition (about 150 cases have been reported) difficult to diagnose if undetected by conventional radiological evaluation and retrograde ureteropyelography may be required. It may be associated with urological or other types of malformations. It is generally asymptomatic and with scant consequences, thus treatment is initially conservative. Surgical excision of the blind bifid ureter is warranted only when complications present. In the present case, prophylactic antibiotic therapy was instituted. At one year follow up, the patient is asymptomatic and urine cultures are negative.

[Enterocystoplasty in the treatment of myelodysplastic bladder]. / La enterocistoplastia en el tratamiento de la vejiga mielodisplásica.

Over the last five years 18 myelodisplastic patients with neurogenic bladder have undergone in our Unit a surgical operation consisting in vesical enlargement with patch-like bowels. They all had incontinence and urinary infections and there was a high percentage of pyelonephritic events. A report on the results from 13 patients whose post-operative evolution is longer than one year is included. Eleven patients were completely and two partially continent; pyelonephritic events have ceased or became more spaced; renal function, assessed by UIV is within normal values or shows improvement in 22 renal units while only one patient, out of 11 pre-operative cases, continues having vesico-renal reflux.

[Infiltrating transitional carcinoma of the bladder. 3. Effect of regional lymph node dissemination on the prognosis]. / Carcinoma transicional infiltrante de vejiga. (3a parte). Influencia de la diseminación a ganglios regionales sobre el pronóstico.

The evolution of 168 patients, 136 of which underwent bilateral lymphadenectomy is analyzed in this paper. In 126 cases it was possible to obtain all the data in order to define N within the T.N.M. rating. With regard to the remaining patients 10, of which we lack the anatomopathological report, and 32 which did not undergo lymphadenectomy, are included under item Nx. During follow-up, metastasis was diagnosed in 60% node-positive patients. We believe it to have been already present at the time of undergoing surgery. Survival was significantly higher in the group without node dissemination than in both negative-nodes and Nx groups. When assessing the nodular dissemination group, patients treated with 2000 rad prior to cystectomy showed higher survival rates: 36% vs 22% and 11% for groups treated with 4500 rad and no radiotherapy. respectively. Metastatic percentage, however, was lower for the group managed with surgery alone (50%) than those treated with pre-operative radiotherapy (73% and 67% with 2000 and 4500 rad, respectively), on the other side, it would seem a contradiction that a 2000 rad dosage should be more effective than a 4500 rad dosage for this group of patients, since theoretically, the latter is closer to the ideal dosage to eradicate the nodular disease. Since 3 of 5 patients have micrometastasis, which we are yet unprepared to detect, all positive-node patients should receive chemotherapy immediately after recovery from surgery.

[Instability of the detrusor. Treatment with oxybutynin chloride (Ditropan) in children]. / Inestabilidad del detrusor. Tratamiento con cloruro de oxibutinina (Ditropan) en niños.

We study the effect of oxybutynin chloride (Ditropan) in a random sample of 24 children with ages ranging from 5 to 14 years, diagnosed as having vesical instability from both the clinical and urodynamic standpoints. These effects were evaluated after a period of treatment that ranged from 10 to 36 months (x = 20). We obtained overall clinical improvement in 87.5%, and improvement of urodynamic alterations in 83.3% of the patients. We single out the beneficial effect of oxybutynin chloride with prolonged treatments, in instability of the detrusor, as well as its good tolerance.